| Holistic Healing Therapy Llc | |
|
6642 Theisen St Dearborn MI 48126-1984 | |
| (313) 414-3093 | |
| Not Available |
| Full Name | Holistic Healing Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6642 Theisen St, Dearborn, Michigan |
| Authorized Official Name and Position | Fatme Ancouni (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 3134143093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holistic Healing Therapy Llc 6642 Theisen St Dearborn MI 48126-1984 Ph: (313) 414-3093 | Holistic Healing Therapy Llc 6642 Theisen St Dearborn MI 48126-1984 Ph: (313) 414-3093 |
| NPI Number | 1326721002 |
|---|---|
| Provider Enumeration Date | 08/09/2023 |
| Last Update Date | 08/05/2024 |
| Certification Date | 08/05/2024 |
| Medicare PECOS PAC ID | 3971965245 |
|---|---|
| Medicare Enrollment ID | O20230817003915 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326721002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Fatme Ancouni |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114457868 PECOS PAC ID: 4284012501 Enrollment ID: I20220527000665 |
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